Do clinicians screen Medicaid patients for syphilis or HIV when they diagnose other sexually transmitted diseases?

Sex Transm Dis. 2003 Sep;30(9):723-7. doi: 10.1097/01.OLQ.0000078652.66397.4C.

Abstract

Background: Patients diagnosed with gonorrhea or chlamydia are at high risk for HIV and syphilis, and should be offered screening for both.

Goal: This study measures HIV and syphilis screening rates among Medicaid patients diagnosed with another sexually transmitted disease (STD).

Study design: Using 1998 Medicaid claims data from 4 states, we identified individuals diagnosed with gonorrhea, urogenital chlamydia, or pelvic inflammatory disease, and then measured the proportion receiving screening tests for HIV and syphilis.

Results: Only 25% of STD-diagnosed Medicaid patients received screening tests for syphilis and only 15% for HIV. We found significant state-to-state variability in screening rates.

Conclusion: Medicaid patients diagnosed with a nonbloodborne STD represent a high-risk group that is not adequately screened for syphilis and HIV despite repeated contact with medical professionals. Interventions should focus on eliminating missed opportunities for screening these high-risk individuals.

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Georgia / epidemiology
  • HIV Infections / diagnosis
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control
  • Health Services Accessibility*
  • Humans
  • Indiana / epidemiology
  • Insurance Claim Review
  • Male
  • Mass Screening / statistics & numerical data*
  • Medicaid*
  • New Jersey / epidemiology
  • Practice Patterns, Physicians'*
  • Risk Factors
  • Sexually Transmitted Diseases / diagnosis*
  • Sexually Transmitted Diseases / epidemiology*
  • Sexually Transmitted Diseases / prevention & control
  • Syphilis / diagnosis
  • Syphilis / epidemiology
  • Syphilis / prevention & control
  • United States / epidemiology
  • Washington / epidemiology